But the couple never imagined that the greatest barrier between them and the family they wanted would be their doctor.

"Right off the bat, [our doctor] mentioned that when it came to insemination, she wouldn't be able to perform it," said Benitez, 37, of Oceanside, Calif. "She had problems with people in same-sex relationships and it was against her religion."

Benitez and Clark, 50, said they were shocked and angry at the doctor's admission but continued to see her at the North Coast Women's Care Medical Group in Encinitas, Calif., because their insurance plan did not offer other clinic options.

The couple says that their doctor assured them another doctor at the clinic would perform the intrauterine insemination (IUI). However, after 11 months of fertility drugs, testing, and an exploratory surgery, all while Benitez and Clark attempted home inseminations to get pregnant, they say every doctor at the clinic declined to perform an IUI for Benitez due to religious reservations.

No Baby for You, Doctors Say

The couple sued Dr. Douglas Fenton and Dr. Christine Brody at the North Coast Women's Care Medical Group for discrimination in 2001 and settled earlier this month for an undisclosed sum after eight years of litigation.

Although this may not be the first time a patient has been denied medical care for personal reasons, Benitez's case demonstrates the narrow path doctors often walk between providing the best health care services and adhering to their own moral, ethical or religious beliefs.

"In general, religious beliefs or gender orientation should not interfere with the rights of an individual to reproduce," said Dr. Sherman Silber, director of the Infertility Center of St. Louis at St. Luke's Hospital in St. Louis, Mo. "If a doctor doesn't want to care for a patient, the doctor has a right to decide who he or she is and isn't going to take care of. But that conflicts with the discrimination issue."

Converging Law, Medicine and Morals

In fact, Benitez's case illustrates how a host of considerations, including law, medical practice and personal rights converge in a tangled system of checks and balances.

A patient has the right to receive the best care possible from their chosen physician, said Dr. Siva Subramanian, professor of pediatrics and obstetrics at Georgetown University Hospital. But a physician has the right to personal beliefs and morals that may influence what they are willing to do medically.

Subramanian pointed out, however, that a physician's beliefs may conflict with state and federal laws governing medical practice -- laws that a licensed physician has agreed to comply with.

In all cases, a physician should make relevant personal beliefs known to patients during the first meeting, Subramanian said. And in cases where personal beliefs conflict with the law, physicians should be prepared to accept the consequences of standing by their beliefs.